Color Doppler sonography examination of partially obstructed kidneys associated with ureteropelvic junction stone before and after percutaneous nephrolithotripsy: Preliminary report

Abstract

Aim: To evaluate resistive index (RI) changes before and after unilateral percutaneous nephrolithotripsy in chronic partially obstructed kidneys due to ureteropelvic junction (UPJ) stones. Methods: Intrarenal RI of obstructed and contralateral normal kidneys of 18 patients were recorded immediately before the operations and at postoperative days 1, 7 and 30. Postoperative RI measurements were compared with baseline values for all patients without grouping and separately for different groups according to the preoperative RI value of the obstructed kidney. Results: Mean age and symptom duration were 27.5 years and 43.8 weeks, respectively. Preoperatively and at all postoperative controls, kidney diameters and renal parenchyma thicknesses were normal in all patients. Mean RI of obstructed kidneys decreased from 0.68 to 0.63 for all patients (P = 0.032), from 0.64 to 0.63 for those with preoperative RI < 0.70 (P = 0.850) and from 0.73 to 0.62 for those with preoperative RI ≥ 0.70 (P = 0.001). In patients with preoperative RI ≥ 0.70 in obstructed kidney, significant RI decreases were recorded at postoperative day 7 and RI differences between obstructed and contralateral kidneys disappeared after then. No difference was present pre‐ and postoperatively between the mean RI of obstructed and contralateral kidneys of the patients with RI < 0.70. Mean RI of contralateral kidneys were normal preoperatively and showed no significant change postoperatively. Conclusions: Preoperative RI levels may indirectly reflect the presence of functionally significant obstruction in chronic obstructed kidneys related to UPJ stones. Patients with RI ≥ 0.70 may have a good indication for a surgical approach. Normalization of high RI occurs rapidly after percutaneous nephrolithotripsy.

Berberine ameliorates renal interstitial fibrosis induced by unilateral ureteral obstruction in rats

“…It is usually considered that the detrimental histologic alterations in the kidney can lead to reduced renal function, and the renal Doppler RI could be used to evaluate renal function, particularly in hydronephrotic kidneys . Therefore, we measured RI to evaluate the renoprotective effect of berberine.…”

“…It is usually considered that the detrimental histologic alterations in the kidney can lead to reduced renal function, and the renal Doppler RI could be used to evaluate renal function, particularly in hydronephrotic kidneys. 12 Therefore, we measured RI to evaluate the renoprotective effect of berberine. As expected, the CDFI examination showed a significant difference between the effect of berberine and vehicle treatment on the RI of obstructed kidneys, which indicates the ameliorative effect of berberine on hydronephrosis induced RIF.…”

“…Kilic et al . proposed that the renal Doppler resistive index (RI) could be used to evaluate renal function, particularly in hydronephrotic kidneys . To date, the effects of berberine on RIF and renal RI in the UUO model remain unclear.…”

Diagnostic imaging in pediatric urolithiasis

“…The resistive index measured in the intrarenal arteries has shown to rise during acute obstruction. The importance of the resistive index (renal arteries) to estimate obstruction and urine propulsion out of the ureteral orifice, however, is controversial [19][20][21][22][23][24][25]. Especially, when compared to NCCT scans, it was quite insensitive [26].…”

Functional evaluation of the urinary tract by duplex Doppler ultrasonography in patients with acute renal colic

“…1,10 The rationale for its use is a change in renal hemodynamic mediated by certain vasoactive mediators due to obstruction. 11,12 As this occurs in the obstructed kidney, the RI of only the obstructed kidney is elevated. Thus, the difference of mean RI between the obstructed and normal contralateral kidney is also significantly elevated in the setting of acute urinary obstruction, which is measured as delta RI.…”